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Open AccessArticle

Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency

Department of Rheumatology and Immunology, Hannover Medical School, 30625 Hannover, Germany
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Authors to whom correspondence should be addressed.
These authors contributed equally.
J. Clin. Med. 2020, 9(4), 1049; https://doi.org/10.3390/jcm9041049
Received: 5 March 2020 / Revised: 2 April 2020 / Accepted: 6 April 2020 / Published: 7 April 2020
The phenotype of primary immunodeficiency disorders (PID), and especially common variable immunodeficiency (CVID), may be dominated by symptoms of autoimmune disorders. Furthermore, autoimmunity may be the first manifestation of PID, frequently preceding infections and the diagnosis of hypogammaglobulinemia, which occurs later on. In this case, distinguishing PID from hypogammaglobulinemia secondary to anti-inflammatory treatment of autoimmunity may become challenging. The aim of this study was to evaluate the diagnostic accuracy of peripheral blood lymphocyte phenotyping in resolving the diagnostic dilemma between primary and secondary hypogammaglobulinemia. Comparison of B and T cell subsets from patients with PID and patients with rheumatic disease, who developed hypogammaglobulinemia as a consequence of anti-inflammatory regimes, revealed significant differences in proportion of naïve B cells, class-switched memory B cells and CD21low B cells among B cells as well as in CD4+ memory T cells and CD4+ T follicular cells among CD4+ T cells. Identified differences in B cell and T cell subsets, and especially in the proportion of class-switched memory B cells and CD4+ T follicular cells, display a considerable diagnostic efficacy in distinguishing PID from secondary hypogammaglobulinemia due to anti-inflammatory regimens for rheumatic disease. View Full-Text
Keywords: hypogammaglobulinemia; secondary hypogammaglobulinemia; primary immunodeficiency; common variable immunodeficiency; methotrexate; DMARD; systemic lupus erythematosus; rheumatoid arthritis; CD4+ T follicular cells; class-switched memory B cells hypogammaglobulinemia; secondary hypogammaglobulinemia; primary immunodeficiency; common variable immunodeficiency; methotrexate; DMARD; systemic lupus erythematosus; rheumatoid arthritis; CD4+ T follicular cells; class-switched memory B cells
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MDPI and ACS Style

Jablonka, A.; Etemadi, H.; Adriawan, I.R.; Ernst, D.; Jacobs, R.; Buyny, S.; Witte, T.; Schmidt, R.E.; Atschekzei, F.; Sogkas, G. Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency. J. Clin. Med. 2020, 9, 1049. https://doi.org/10.3390/jcm9041049

AMA Style

Jablonka A, Etemadi H, Adriawan IR, Ernst D, Jacobs R, Buyny S, Witte T, Schmidt RE, Atschekzei F, Sogkas G. Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency. Journal of Clinical Medicine. 2020; 9(4):1049. https://doi.org/10.3390/jcm9041049

Chicago/Turabian Style

Jablonka, Alexandra; Etemadi, Haress; Adriawan, Ignatius R.; Ernst, Diana; Jacobs, Roland; Buyny, Sabine; Witte, Torsten; Schmidt, Reinhold E.; Atschekzei, Faranaz; Sogkas, Georgios. 2020. "Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency" J. Clin. Med. 9, no. 4: 1049. https://doi.org/10.3390/jcm9041049

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